Close to a million people in the US have an addiction to opiates, which carries a risk of premature death owing to the likelihood of overdose and adverse health consequences such as liver disease and HIV from IV drug use. However, effective treatment with methadone maintenance therapy can greatly reduce these risks, as well as helping addicts to avoid criminal activities, achieve a more stable family life and hold down employment. As the CDC explains, methadone works by blocking the euphoric and sedative effects of illicit and prescription opiates by binding to the same brain receptors, while reducing withdrawal symptoms and cravings. While methadone is considered a safe treatment when used under supervision, which can be continued for months or even years, there are still risks associated with its use, as like any medication it does have a range of potential side-effects. Screening which opiate addicts are appropriate for methadone treatment and tailoring the treatment accordingly can reduce the risk of adverse effects.
Methadone Side Effects
Although there are a range of side effects of methadone, some are often only temporary and clear up as your body adjusts to the medication. Examples of these methadone short-term effects include anxiety, irritability, reduced libido, constipation, vision changes, weight changes and alterations to a woman’s menstrual cycle.
However, there are other symptoms that you should never ignore, so you should always seek medical advice if you notice any of the following unwelcome signs of methadone use:
- Drowsiness or altered mental state
- Altered breathing or pulse
- Chest Pain
- Bloody urine or stools
Although methadone accounts for just 2% of opioid prescriptions, it is associated with over 30% of opioid overdose deaths. While this is concerning, it is possible to reduce the likelihood of adverse events linked to methadone, as the SAMHSA discusses some people are at greater risk. For instance, methadone can interact with a range of substances that are also abused, including alcohol, benzodiazepines, cocaine, marijuana and other opiates, which may result in respiratory depression, an irregular heartbeat and drowsiness. When this is the case, receiving help with multi-substance abuse is therefore crucial if you are to safely take methadone. Similarly, methadone may interact with prescription medications, but your doctor should check that any you take are compatible with this opiate maintenance treatment. Undiagnosed heart problems may also increase the risk of cardiac abnormalities on methadone, so ideally you should receive screening tests before commencing treatment. If your doctor gradually increases your methadone dose and monitors your symptoms carefully, this also makes an unfavorable outcome less likely.
If you have an addiction to one opiate, you may worry that introducing methadone may simply swap one addiction for another. However, as the National Institute on Drug Abuse points out, this is usually not the case. As methadone is prescribed under controlled conditions and administered orally, it is not the same as taking heroin or illicit opiates. Methadone also acts very differently from abused opiates, which quickly flood your brain leading to feelings of euphoria, unlike maintenance therapy that has a slow rate of onset and keeps opiate levels stable. You therefore don’t achieve a high from methadone or crave it, and you will find that if you abuse opiates you won’t achieve the same effects as you did before.
However, methadone abuse is another matter. Although methadone doesn’t offer the same high as opiates, it is used recreationally for its analgesic and sedative properties, with users either taking the drug orally or by way of an injection into a vein or muscle. Effects are felt within 30 minutes of ingestion, but injecting methadone allows users to achieve a quicker hit. While it is difficult to estimate the true extent of how many people are abusing this opiate maintenance therapy, the number of people abusing “other opiates” (in which methadone belongs) is on the increase. Previous Government data has also highlighted concerns about abuse of methadone by teens, with close to 1% of high school students using the drug at least once. Not only is this practice illegal, as methadone is a schedule II controlled drug, but there are risks to physical and mental health, particularly if tolerance and dependence develop, which make an overdose more likely.
Like other drugs, repeated use of methadone leads to tolerance, as your body adapts to its effects, so you are less likely to feel sleepy or experience the impact that it has on your cardiovascular system or lungs. However, tolerance typically encourages you to take higher doses of methadone, which can lead to physical and psychological dependence. Your body therefore becomes reliant on methadone, so if you even temporarily don’t get a fix, you will experience a range of symptoms that are a sign your body is now dependent on the drug. These methadone withdrawal symptoms include minor problems such as watering eyes, a running nose and dilated pupils to more uncomfortable symptoms such as muscle pain, digestive upset, sweating and chills, low mood, anxiety, feeling restless and irritable, and insomnia. As methadone is a synthetic opiate, addiction can occur and when this is the case you will find that you can’t give up your use no matter how much you want to.
Treatment for an addiction to methadone is possible with the help of buprenorphine. This partial opiate agonist can reduce withdrawal symptoms and cravings for methadone, helping you to function more easily in your day to day life while you complete treatment. Using the buprenorphine formulation Suboxone, which also contains naloxone, is particularly helpful if you are an IV methadone user, as it dissuades this habit. When used alongside specialist addiction therapy, buprenorphine can help you to successfully kick your addiction.
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